Provider Demographics
NPI:1568020352
Name:CHANDRASHEKHAR, HEMAMALINI (MDS)
Entity type:Individual
Prefix:DR
First Name:HEMAMALINI
Middle Name:
Last Name:CHANDRASHEKHAR
Suffix:
Gender:
Credentials:MDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10825 113TH CT NE APT K202
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-5005
Mailing Address - Country:US
Mailing Address - Phone:252-629-1154
Mailing Address - Fax:
Practice Address - Street 1:13501 100TH AVE NE STE 110
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-5209
Practice Address - Country:US
Practice Address - Phone:425-296-3338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-05
Last Update Date:2025-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE61556525122300000X, 1223X2210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X2210XDental ProvidersDentistOrofacial Pain
No122300000XDental ProvidersDentist